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Weekly Chest CasesArchive of Old Cases

Case No : 1426 Date 2025-02-17

  • Courtesy of Jeong Joo Woo / Nowon-Eulji University Hospital
  • Age/Sex 44 / F
  • Chief ComplaintWorkup of proven breast cancer
  • Figure 1
  • Figure 2
  • Figure 3
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  • Figure 5
  • Figure 6

Diagnosis With Brief Discussion

Diagnosis
Sclerosing pneumocytoma
Radiologic Findings
• A chest PA radiograph revealed a poorly defined nodule in the right middle lobe zone (RMLZ).
• Apart from the known right breast cancer, pre- and contrast-enhanced CT images showed a well-defined, approximately 15mm solid nodule in the right middle lobe (RML). The nodule exhibited moderate enhancement with a subtle inhomogeneous pattern. A so-called “vessel overlying sign” was observed on sagittal image. No findings, such as an air-gap sign or ground-glass opacity halo, were associated with the nodule.
• On a PET-CT scan, performed after breast cancer surgery, the nodule demonstrated mild FDG uptake with an SUV of 1.4.
Brief Review
PSP is a tumor, mostly benign in nature, with a proven pulmonary epithelial origin. PSP affects most frequently women in Eastern countries.
On CT, it appears as a peripherally located, well circumscribed, homogenously enhancing lesion. A few nonspecific signs have been described in CT, including marginal pseudo-capsule sign, overlying vessel sign, air-gap sign and halo sign, but these signs are not universal, and hence preclude a diagnosis based on radiology alone.
Calcification is rare and cavitation does not occur. They are described to be hypo metabolic on FDG-PET, although not always. A magnetic resonance imaging (MRI) does not provide any additional information towards the diagnosis.
Please refer to
Case 142, Case 148, Case 168, Case 268, Case 1023, Case 1035, Case 1118, Case 1245, Case 1254,
References
1. Manini C, Vezzini S, Conte A et al. Revisiting Pulmonary Sclerosing Pneumocytoma.Clin. Pract. 2024, 14(4), 1440-
2. Shin SY, Kim MY, Oh SY, et al. Pulmonary sclerosing pneumocytoma of the lung: CT characteristics in a large series of a tertiary referral center. Medicine (Baltimore). 2015 Jan;94(4):e498.
3. Lim JH, Lee N, Choi DW, et al. Pulmonary sclerosing pneumocytoma mimicking lung cancer: Case report and review of the literature. Thorac Cancer. 2016 Jul;7(4):508-11.
Keywords

No. of Applicants : 57

▶ Correct Answer : 25/57,  43.9%
  • - medical scanning , Japan HIROAKI ARAKAWA
  • - Affilitated Hospital of Jining Medical college , China JIANG SHENG HUA
  • - Kyoto City Hospital , Japan YUSUKE UTSUNOMIYA
  • - , Korea (South) DONG-HO BANG
  • - Secomedic Hospital , Japan FUMINORI MIYOSHI
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - University of Yamanashi , Japan TAKAAKI HASHIMOTO
  • - University of Yamanashi , Japan HIROYUKI MORISAKA
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - , Japan YOSHIKI ISHII
  • - University of Yamanashi , Japan HIROAKI WATANABE
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - , Japan SHUNJIRO NOGUCHI
  • - Mie university , Japan SHIKO OKABE
  • - Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
  • - The First Affiliated Hospital of Nanjing Medical University , China TENG ZHANG
  • - Kyoto University , Japan SHO KOYASU
  • - Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Fukuoka university , Japan KEISUKE SATO
  • - Kantou Rousai Hospital , Japan KAORU SUMIDA
  • - Matsunami General Hospital , Japan TARO TAKEDA
  • - , Japan YUMI MAEHARA
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
▶ Correct Answer as Differential Diagnosis : 11/57,  19.3%
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Kyoto University , Japan AKIHIKO SAKATA
  • - Oita university , Japan AYUMI KAMEI
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) CHAEHUN LIM
  • - Presbyterian Medical Center , Korea (South) HANLIM SONG
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Toyota Kosei Hospital , Japan YUKI HAYASHI
  • - University of Yamanashi , Japan KOJIRO ONOHARA
  • - Jiangsu province hospital , China WANGJIAN ZHA
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